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34 Cards in this Set
- Front
- Back
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what is the m/c cause of dementia?
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Alzheimer's disease (senile dementia of Alzheimer type)
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what are the si/sx of alzheimer's dz?
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1. dementia
2. anxiety 3. hallucination/delusion 4. tremor |
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what may be found in Down's sx pts at younger ages (30-40)?
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Alzheimer's dz
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how do you dx Alzheimer's dz?
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1. clinical
2. definitive diagnosis only possible at autopsy |
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what is the tx for Alzheimer's dz?
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1. anticholinesterase inhibitor can slow dementia
2. antidepressants for psychosis 3. antipsychotics for psychosis |
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what is the px for Alzheimer's dz?
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inevitable decline in function usually over approx. 10 yr
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dementia and delirium can both be defined as:
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both cause:
1. global decline in cognition 2. memory, personality, motor, and sensory deficits |
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what are the characteristics of dementia?
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1. constant, progressive course
2. usually not reversible 3. constant problem, no daily pattern 4. consciousness is normal 5. no hallucinations 6. tremors not present |
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what are the characteristics of delirium?
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1. sudden onset, saxing and saning daily
2. almost always reversible 3. usually worse at night (sun-downing) 4. consciousness is altered (obtunded state) 5. often classically visual hallucinations 6. tremors ofen present (asterixis, e.g.) |
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what are the causes of demnetia?
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1. alzheimer's
2. multi-infarct 3. Pick's dz 4. alcohol 5. brain infxn/tumor 6. malnutrition (thiamine/B12 def) |
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what are the causes of delirium?
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1. systemic infxn/neoplasm
2. drugs (esp. narcotics and benzodiazepines) 3. stroke, heart dz 4. alcoholism 5. uremia 6. electrolyte imbalance 7. hyper/hypoglycemia |
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what is the tx for delirium?
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1. tx underlying cause
2. control sx c/ haloperidol instead of sedatives--pts are often given benzodiazepines or sedatives for agitation, but these drugs often exacerbate the deliriumb/c they disorient pts even more |
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what should you NOT give to tx pts with delirium?
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No sedatives--pts are often given benzodiazepines or sedatives for agitation, but these drugs often exacerbate the delirium b/c they disorient pts even more!!
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what are si/sx of multi-infarct dementia?
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1. acutre stepwise decrease in neurologic fxn
2. multiple focal defictis on exam 3. hypertension 4. old infarcts by CT or MRI |
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how do you dx and tx multi-infarct dementia?
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1. dx by clinical and radiographic exam
2. tx=prevent future infarcts by decreasing cardiovascular risks |
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how do you characterize Pick's dz?
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1. clinically resembles Alzheimer's
2. more common in women 3. onset at younger age (50s) 4. frontotemporal dementia |
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how do you dx Pick's dz?
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1. MRI--shows symmetric frontal or temporal atrophy
2. confirm by autopsy 3. Tx/Px as per Alzheimer's |
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what are si/sx of Parkinson's dz?
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1. syndrome of tremor
2. cog-wheel rigidity 3. bradykinesia 4. classic shuffling gait 5. masklike facies 6. dementia from loss of dopaminergic neurons in substantia nigra |
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what is the pathophys of Parkinson's dz?
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*loss of dopaminergic neurons in the substantia nigra
*typically progresses over yrs despite tx |
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what are ddx of Parkinson's dz?
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1. severe depression (bradykinesia and flat affect)
2. intoxication (e.g. manganese, synthetic heroin) 3. phenothiazine side effects 4. rare neurodegenerative dz |
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what are tx for Parkinsons's dz?
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1. sinemet (levodopa=carbidopa)--best for bradykinesia
2. anticholinergics (benztropine/trihexyphenidyl) for tremor 3. amantadine--increases dopamine release, effective for mild dz 4. surgical pallidotomy for refractory cases |
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which Parkinson's med is best for bradykinesia?
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sinement (levodopa=carbidopa)
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what are the si/sx of Huntingont's chorea?
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1. progressive choreiform movements of all limbs
2. ataxic gait 3. grimacing 4. dementia 5. pts in usually in 30s-50s |
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what is the pathophys of Huntingon's chorea?
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1. autosomal CAG triplet repeat expansion in HD gene
2. atrophy of striatum (esp. caudate nucleus) 3. neuronal loss and gliosis |
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what is the dx, tx, and px of Huntington's chorea?
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dx=MRI--will see atrophy of caudate nucleus (striatum) and pos. fam hx
tx=supportive px=death inevitable |
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what are the si/sx of ALS (amyotrophic lateral sclerosis)--motor neuron dz?
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1. Upper and lower motor neuron dz
2. m. weakness c/ fasciculations (anterior motor neurons) 3. progressing to denervation atrophy 4. hyperreflexia 5. spasticity 6. difficulty speaking/swallowing |
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what is the dx, tx, and px of ALS?
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dx=clinical hx, physical findings
tx/px= supportive, death inevitable, ususally from respiratory failure |
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what is the dx of cerebral palsy?
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1. group of conditions that affect control of movement and posture
2. in approx 70% of cases, CP results from events occurring before birth that can disrupt nml development of the brain |
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what are si/sx of CP?
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1. range from mild to severe
2. condition does not worsen as the child gets older |
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what is spastic cerebral palsy?
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1. m/c form of CP
2. pt's muscles are sitiff, making movement difficult |
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what is athetoid or dyskinetic cerebral palsy?
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1. approx. 10-20% of CP
2. can affect the entire body 3. characterized by fluctuations in m. tone 4. a/c uncontrolled movements |
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what is ataxic cerebral palsy?
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1. approx. 5-10% of CP
2. ataxic form affects balance and coordination |
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what tx may help to decrease spasticity in cerebral palsy?
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1. botox injected into spastic muscles
2. Baclofen (centrally acting m. relaxant) |
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what form of tx may permanetly reduce spasticity?
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1. selective dorsal rhizotomy may permanently reduce spasticity by cutting some of the nerve fibers that are contributing most to spasticity
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